Five of the 10 leading causes of disability worldwide are mental problems (major depression, schizophrenia, bipolar disorders, alcohol use and obsessive-compulsive disorders).These disorders – together with anxiety, depression and stress – have a definitive impact on any working population and should be addressed within that context. They may also develop into long-term disorders with accompanying forms of disability. With respect to the impact of mental health problems at work, a major study suggested a prevalence of 18.2% for any mental health problems. Work impairment is always higher in workers with comorbid psychiatric disorders (more than one disease at the same time). “The average number of psychiatric work days loss was 6 days per month per 100 workers, and the average number of psychiatric work cutback days was 31 days per month per 100 workers.” Mental health can broadly be grouped into 3 main categories;
- Symptoms associated with mental ill health such as sleep problems, fatigue, irritability and worry that do not meet criteria for a diagnosis of a mental disorder. These affect one sixth of the working age population at any one time and can impair a person’s ability to function at work.
- Common mental disorders, particularly anxiety and depression, affect a further one sixth of the working age population. These would be treated should they come to the attention of a healthcare professional but most often are not treated in South Africa given the stigma around mental health conditions. People with a common mental disorder are four to five times more likely both to be permanently unable to work than the rest of the population increasing staff turnover and the associated costs. They are three times more likely to be receiving social grant payments.
- Severe mental illness, such as schizophrenia, bipolar disorder or severe depression affects about 1% of the working age population. People with these conditions usually require continuing and sometimes intensive treatment and care. Best estimates are that between 10% and 20% of this group are in paid employment.An average of 12-15% or all referrals into LifeAssist in South Africa are for trauma related incidents.